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NPI Code Detail

MEDICARE: JOHN YEBOAH

MEDICARE:   JOHN  YEBOAH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172A00000XDriver

General Provider Information

NPI Number : 1225683147
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN YEBOAH
Provider Business Mailing Address
First Line : 53 EASTPOINTE RIDGE DR APT 207
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1593
Country : US
Telephone Number : 740-739-2615
Fax Number :
Provider Business Practice Location Address
First Line : 53 EASTPOINTE RIDGE DR APT 207
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1593
Country : US
Telephone Number : 740-739-2615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2019
Last Update Date : 08/07/2019

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Directions to “ JOHN YEBOAH ” Practice Location

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